A Scoping Review of Financial Elder Exploitation Interventions

Abstract Elder financial exploitation (EFE), defined by the National Center for Elder Abuse (2021) as “the misappropriation of an older person’s money or property,” is a continuing public health crisis shown to cost individuals at least $2.9 billion a year (MetLife Mature Market Institute, 2011). Many believe this impact will increase exponentially due to the effects of COVID-19. In fact, a recent study conducted by Chang & Levy (2021) found that the prevalence of elder abuse as a whole increased from 1 in 10 older adults to 1 in 5 in the past year. Although increased collaboration between state attorneys general, Adult Protective Services, and financial institutions has driven progress in the field; there is still little known regarding EFE interventions. To address this issue, this study conducts a scoping review of the EFE intervention literature. This approach was chosen over a systematic review primarily due to the lack of a universal definition of EFE, as well as the limited number of studies available delineating between EFE and elder abuse as a whole. The main findings of the review reveal that current EFE intervention practices are focused on preventing abuse before it occurs by addressing risk factors for abuse in older adults; and are largely reliant on Adult Protective Services and the legal system. This finding is significant because state policies differ in their qualifications of EFE, thus leaving many older adults vulnerable and unprotected. Further interventions that address EFE while it is occurring and alignment across governing bodies are needed.

reported SCD, compared with 10.2% (95%CI:9.7-10.7) of non-caregivers (p<0.0001). Caregivers with SCD had more chronic health conditions, lower educational attainment, and were less likely to be married or employed than caregivers without SCD, despite a similar age distribution. Caregivers with SCD were also more likely than caregivers without SCD to report fair or poor health, frequent mental distress, a history of depression, and frequent activity limitations. SCD may negatively impact caregivers' health, function, and ability to provide care. With the anticipated increases in the need for caregiving, it is critical to understand the cognitive health of caregivers to better support caregivers and care recipients. Compared to non-dementia caregivers, family/friend caregivers of individuals with dementia experience more negative caregiving consequences. One reason is the myriad of negatively impacted life domains including: managing symptoms; family communication; financial and legal matters; and finding and coordinating services. Few psychometrically tested measures exist for assessing the range of potential unmet needs of dementia caregivers. Such a measure would describe the frequency and correlates of unmet needs and provide a key outcome for intervention research. This study tested the psychometric properties of a comprehensive measure of unmet needs, the BRI Unmet Need Instrument. Data from 192 family/friend dementia caregivers was used to test reliability and four validity types. Results showed total unmet needs, as well as its nine subscales, had good reliability (Cronbach's alpha .70 -.95). Discriminant validity was confirmed through factor analyses of the 45 unmet needs and items in measures of depression and care-related strain. Unmet need items loaded on separate factors that were deemed acceptable (.72-.38). Predictive validity was assessed by the association with depression, which was significant and an acceptable range (r = .22, p < .01). Convergent validity was confirmed by significant associations with three caregiver strain measures, mastery (r = .40, p <.01), emotional strain (r = .19, p < .01), and relationship strain (r = .15, p <.05). Good structural validity for nine predetermined unmet needs subscales was found using principal component analysis (loadings = .82-.39). Results suggest the BRI Unmet Needs Instrument is a ready-to-use, reliable and valid comprehensive measure.

A SCOPING REVIEW OF FINANCIAL ELDER EXPLOITATION INTERVENTIONS
Stephanie Skees, Washington University in St. Louis, Saint Louis, Missouri, United States Elder financial exploitation (EFE), defined by the National Center for Elder Abuse (2021) as "the misappropriation of an older person's money or property," is a continuing public health crisis shown to cost individuals at least $2.9 billion a year (MetLife Mature Market Institute, 2011). Many believe this impact will increase exponentially due to the effects of COVID-19. In fact, a recent study conducted by Chang & Levy (2021) found that the prevalence of elder abuse as a whole increased from 1 in 10 older adults to 1 in 5 in the past year. Although increased collaboration between state attorneys general, Adult Protective Services, and financial institutions has driven progress in the field; there is still little known regarding EFE interventions. To address this issue, this study conducts a scoping review of the EFE intervention literature. This approach was chosen over a systematic review primarily due to the lack of a universal definition of EFE, as well as the limited number of studies available delineating between EFE and elder abuse as a whole. The main findings of the review reveal that current EFE intervention practices are focused on preventing abuse before it occurs by addressing risk factors for abuse in older adults; and are largely reliant on Adult Protective Services and the legal system. This finding is significant because state policies differ in their qualifications of EFE, thus leaving many older adults vulnerable and unprotected. Further interventions that address EFE while it is occurring and alignment across governing bodies are needed. Introduction: One of the smartest ways to prepare for declines in financial decision making capacity is to appoint an agent under power of attorney for finances and to share important financial information and preferences with trusted family or friends. Yet only 12% of older Americans with children think that they'll need help with their finances as they age, and more than half are uncomfortable talking about their finances with children.

I MIND MY OWN BUSINESS AND EXPECT OTHERS TO DO THE SAME: CONVERSATIONS ABOUT DECLINING FINANCIAL CAPACITY
Method: We conducted four in-depth interviews with older adults and four focus groups with Black, Latino, low income, and low-middle income adults aged 65 and older. An average of 9 participants were in each 2-hour focus group.
Results: Barriers included lack of awareness, denial of future changes in capacity, lack of trustworthy surrogate decision-makers, shame about one's financial situation, desire for privacy, fear of being a burden, and resistance to overtures by children. Barriers differed by ethnicity and socioeconomic status, with lower income older adults having less knowledge of advance planning and Powers of Attorney.
Implications: Significant education is needed around Powers of Attorney and how to begin the advance planning process. Study findings informed the Thinking Ahead Roadmap, a guide to facilitate planning and communication around future money management. The Roadmap uses an empowerment framework to motivate individuals to appoint trusted financial advocates and prepare them for a smooth transition in money management, thereby reducing risk of exploitation, costly mistakes, and family conflict.

IDENTITY THEFT AND OLDER ADULTS: HOW MINORITIES AND THE POOR SUFFER THE WORST CONSEQUENCES
Marguerite DeLiema, 1 David Burnes, 2 and Lynn Langton, 3 1. University of Minnesota, Twin Cities, SAINT PAUL,Minnesota,United States,2. University of Toronto,Toronto,Ontario,Canada,3. RTI International,RTI International,District of Columbia,United States Society's growing reliance on technology to transfer and store private information has created more opportunities for identity thieves to access personal data. Prior work using data from the National Crime Victimization Survey (NCVS) Identity Theft Supplement (ITS) showed that baby boomers were significantly more likely than Millennials to be victims of identity theft and that older people and minorities experience more severe economic and psychological consequences. This study examines how socioeconomic status, demographic characteristics, and incident-specific factors relate to how much money is stolen during identity theft, the likelihood of experiencing out-of-pocket costs, and emotional distress among identity theft victims age 65 and older. Using combined data from the 2014 and 2016 NCVS-ITS, this study examines the correlates of financial and psychological consequences of identity theft among 2,307 victims age 65 and older. Older Black victims are more likely to have greater amounts of money stolen and are more likely feel distressed than older non-Latino white identity theft victims. The most disadvantaged older adults living at or below the federal poverty level are nearly five times as likely to suffer out-ofpocket costs. The length of time information is misused and the hours spent resolving identity theft are significantly associated with emotional distress. More than one-third of older victims experience moderate to severe emotional distress following identity theft, and those who can least afford it suffer out-of-pocket costs. Greater advocacy and psychological support are needed to help older adults recover, in addition to tools to protect their personal information from misuse. Mass marketing scams are some of the most common frauds in America, and include scams perpetrated through the mail. A growing body of research indicates that older adults face a greater risk of victimization due to age-related changes in cognitive functioning and social isolation, and may be more likely to fall victim repeatedly. The aim of this study is to determine the frequency of repeat mass marketing fraud (revictimization) among older adults and patterns of victimization associated with age, scam type, seasonality, and geography. We use two decades of non-public administrative data from the United States Postal Inspection Service (USPIS). These databases were seized during law enforcement investigations of mass mailing scam organizations and contain more than 2 million unique U.S. victims and their